CVS Health Corp (CVS) 2024 Q3 法說會逐字稿

Good morning, and thank you all for attending the CVS Health third quarter 2024 earnings call and webcast.

早安，感謝大家參加 CVS Health 2024 年第三季財報電話會議和網路廣播。

My name is Brika, and I will be your moderator for today.

我叫 Brika，我將擔任今天的主持人。

(Operator Instructions) I would now like to pass the conference over to your host, Larry McGrath at CVS Health.

（操作員指示）我現在想將會議轉交給您的主持人 CVS Health 的 Larry McGrath。

Thank you.

謝謝。

You may proceed, Larry.

你可以繼續了，拉里。

Good morning, and welcome to the CVS Health third quarter 2024 earnings call and webcast.

早上好，歡迎參加 CVS Health 2024 年第三季財報電話會議和網路廣播。

I'm Larry McGrath, Chief Strategy Officer.

我是首席策略長拉里·麥格拉思。

I'm joined this morning by David Joyner, President and Chief Executive Officer; and Tom Cowhey, Chief Financial Officer.

今天上午，總裁兼執行長 David Joyner 也加入了我的行列。和首席財務長湯姆考伊。

Following our prepared remarks, we'll host a question-and-answer session that will include additional members of the leadership team.

在我們準備好的發言之後，我們將舉辦問答會議，領導團隊的其他成員也將出席。

Our press release and slide presentation have been posted to our website, along with our Form 10-Q filed this morning with the SEC.

我們的新聞稿和幻燈片演示以及今天早上向 SEC 提交的 10-Q 表格已發佈到我們的網站上。

Today's call is also being broadcast on our website, where it will be archived for one year.

今天的電話會議也在我們的網站上播出，並將存檔一年。

During this call, we'll make certain forward-looking statements.

在這次電話會議中，我們將做出某些前瞻性陳述。

Our forward-looking statements are subject to significant risks and uncertainties that could cause actual results to differ materially from currently projected results.

我們的前瞻性陳述面臨重大風險和不確定性，可能導致實際結果與目前預測結果有重大差異。

We strongly encourage you to review the reports we file with the SEC regarding these risks and uncertainties, in particular, those that are described in the cautionary statement concerning forward-looking statements and risk factors in our most recent annual report filed on Form 10-K, our quarterly reports on Form 10-Q filed this morning and our recent filings on Form 8-K, including this morning's earnings press release.

我們強烈建議您查看我們向 SEC 提交的有關這些風險和不確定性的報告，特別是我們在 10-K 表格上提交的最新年度報告中有關前瞻性陳述和風險因素的警告聲明中描述的報告、我們今天早上提交的10-Q 表格季度報告以及我們最近提交的8-K 表格的季度報告，包括今天早上的收益新聞稿。

During this call, we'll use non-GAAP measures when talking about the company's financial performance and financial condition, and you can find a reconciliation of these non-GAAP measures in this morning's press release and in the reconciliation document posted to the Investor Relations portion of our website.

在本次電話會議中，我們將在討論公司的財務表現和財務狀況時使用非GAAP 衡量標準，您可以在今天上午的新聞稿以及發佈在投資者關係部的對帳文件中找到這些非GAAP 衡量標準的調節表我們網站的一部分。

With that, I'd like to turn the call over to David.

說到這裡，我想把電話轉給大衛。

David?

大衛？

Thank you, Larry, and good morning, everyone.

謝謝拉里，大家早安。

Before I begin, I would like to thank Karen Lynch for her years of leadership, dedication and strategic vision.

在開始之前，我要感謝凱倫·林奇多年來的領導、奉獻和戰略遠見。

Karen is a friend to me and many others across the CVS Health organization, and we wish her all the best.

凱倫 (Karen) 是我和 CVS Health 組織中許多其他人的朋友，我們祝福她一切順利。

I am incredibly honored to lead CVS Health during this critical time.

我非常榮幸能夠在這個關鍵時刻領導 CVS Health。

My entire career is deeply connected with this enterprise.

我的整個職業生涯都與這個企業息息相關。

When I returned to CVS Health in 2023, it was because of my strong belief in our purpose and strategy.

當我於 2023 年重返 CVS Health 時，是因為我對我們的宗旨和策略抱持著堅定的信念。

Today, CVS Health serves 185 million people across the US, and we are uniquely positioned to help them navigate their health care journey.

如今，CVS Health 為全美 1.85 億人提供服務，我們擁有獨特的優勢來幫助他們順利完成醫療保健之旅。

In the past few weeks since I took on this role, I have seen firsthand the dedication, pride and commitment of our employees to CVS Health and our vision to deliver lower cost better experiences and better health outcomes for our members, clients and patients.

自從我擔任這項職務以來的過去幾週，我親眼目睹了我們的員工對CVS Health 的奉獻、自豪和承諾，以及我們為會員、客戶和患者提供更低成本、更好的體驗和更好的健康結果的願景。

I began my career at Aetna and have spent the last 37 years managing health care services teams with the focus on driving innovation, strong execution and consistent financial performance.

我的職業生涯始於 Aetna，在過去 37 年裡一直管理醫療保健服務團隊，重點是推動創新、強大的執行力和穩定的財務表現。

Our career has been defined by navigating through change and evolving markets.

我們的職業生涯是透過駕馭變化和不斷發展的市場來定義的。

As the leader of Caremark, I engage with health plans, employers, pharmacies and the broader health care delivery system in our country.

身為 Caremark 的領導者，我與我國的健康計畫、雇主、藥局和更廣泛的醫療保健提供系統接觸。

These experiences gave me a diverse set of perspectives on the challenges and opportunities inherent to our system.

這些經驗讓我對我們系統固有的挑戰和機會有了不同的看法。

I've mobilized teams who have helped reshape the pharmacy benefit landscape by lowering cost, increasing transparency and driving greater accessibility.

我動員了一些團隊，透過降低成本、提高透明度和提高可及性，幫助重塑了藥品福利格局。

Many of those innovations have been made possible by integrating the assets across this enterprise.

其中許多創新都是透過整合整個企業的資產而實現的。

At CVS Health, each of our businesses is formidable in its own right.

在 CVS Health，我們的每項業務本身都非常強大。

We have the leading PBM, the best-run pharmacy in this country, a storied franchise through Aetna and industry-leading health care delivery assets.

我們擁有領先的 PBM、美國營運最好的藥房、Aetna 的傳奇特許經營權以及業界領先的醫療保健服務資產。

Our collection of businesses and omnichannel capabilities allow us to lead the industry forward with innovative and market-moving solutions.

我們的業務集合和全通路能力使我們能夠透過創新和市場驅動的解決方案引領產業前進。

We were pioneers in advancing the biosimilar adoption by establishing a co-manufacturing capacity through court office.

我們是透過法院辦公室建立聯合製造能力來推動生物相似藥採用的先驅。

Making the necessary formulary changes with Caremark and executing through our CVS specialty operations.

透過 Caremark 進行必要的處方變更，並透過我們的 CVS 專業營運執行。

Through our leadership and innovation, we were able to drive down commercial specialty trend for clients that use our integrated biosimilar approach to 1.3%, the lowest level in recent history.

透過我們的領導力和創新，我們能夠將使用我們的綜合生物相似藥方法的客戶的商業專業趨勢降低至 1.3%，這是近年來的最低水準。

We continue to expand our product offering and drive innovation for Aetna's self-insured customers.

我們繼續擴大我們的產品範圍，並為 Aetna 的自保客戶推動創新。

Last month, we introduced Simple Pay a differentiated offering for our commercial customers that provides greater price certainty before a visit or treatment.

上個月，我們為商業客戶推出了 Simple Pay 一項差異化服務，可在就診或治療前提供更大的價格確定性。

Instead of bills and benefit details, members received just one simple monthly statement that summarizes all of their medical and pharmacy claims.

會員只收到一份簡單的月度報表，而不是賬單和福利詳細信息，其中總結了他們所有的醫療和藥品索賠。

This offering provides a simpler end-to-end member experience and access to affordable, quality innovative health care for members and plan sponsors.

該產品為會員和計劃發起人提供了更簡單的端到端會員體驗，並提供了負擔得起的優質創新醫療保健服務。

In addition, this product has been shown to drive a 60% increase in the use of top quality providers and a 12% total cost of care savings for employers and members.

此外，該產品已被證明可使頂級服務提供者的使用量增加 60%，並為雇主和會員節省 12% 的總護理成本。

Last month, BMS released its 2025 star ratings.

上個月，BMS 發布了 2025 年星級評級。

CVS Health's integrated teams helped Aetna deliver an exceptional result.

CVS Health 的綜合團隊幫助 Aetna 取得了卓越的成果。

We built upon our strong momentum from last year with 88% of our Medicare Advantage members in 4-star plans or higher and more than 2 out of every 3 Aetna MA members and a planned rated 4.5 stars.

我們在去年的強勁勢頭基礎上再接再厲，88% 的 Medicare Advantage 會員享有 4 星級或更高級別的計劃，每 3 名 Aetna MA 會員中就有超過 2 名會員享有 4.5 星級的計劃。

Our commitment to outstanding service resulted in our highest ever member experience score since CMS launched the quality bonus or program in 2012.

自 CMS 於 2012 年推出品質獎金或計劃以來，我們對卓越服務的承諾使我們獲得了有史以來最高的會員體驗評分。

This was an impressive result particularly as CMS continues to raise the bar on what it takes to achieve a 4-star rating.

這是一個令人印象深刻的結果，特別是在 CMS 不斷提高獲得 4 星評級所需的標準的情況下。

Our success in this crucial area was achieved by enhancing our cross-enterprise processes and driving focused and deliberate execution, strengthening our position for the future.

我們在這一關鍵領域取得的成功是透過加強我們的跨企業流程並推動專注和深思熟慮的執行來實現的，從而鞏固了我們未來的地位。

This framework and approach are critical elements as I look to lead this organization through the opportunities and challenges ahead.

當我希望帶領這個組織應對未來的機會和挑戰時，這個框架和方法是關鍵要素。

It will also require the right leadership team.

它還需要合適的領導團隊。

Today, we announced two leadership appointments that will help us drive better performance across the enterprise and at Aetna specifically.

今天，我們宣布了兩項領導層任命，這將幫助我們推動整個企業、特別是 Aetna 取得更好的表現。

First, Prem Shaw, who has been running our pharmacy and consumer wellness business is elevated to Group President and will now also be responsible for the Health Services segment.

首先，一直負責我們的藥局和消費者健康業務的 Prem Shaw 被提升為集團總裁，現在也將負責健康服務部門。

Second, we appointed Steve Nelson as President of Aetna.

其次，我們任命 Steve Nelson 為 Aetna 總裁。

Steve is an industry veteran who has successfully led diverse managed care companies and driven innovation and growth throughout his career.

史蒂夫是一位行業資深人士，他成功領導了多元化的管理式醫療公司，並在整個職業生涯中推動了創新和成長。

Steve was a former CEO of United Healthcare and held several leadership roles with a proven track record of delivering growth, profitability, improved employee engagement and customer satisfaction.

史蒂夫是聯合醫療保健公司的前首席執行官，並擔任過多個領導職務，在實現成長、盈利、提高員工敬業度和客戶滿意度方面擁有良好的記錄。

I am confident both Prem and Steve will help us advance our strategy and enable us to realize opportunities across our businesses.

我相信 Prem 和 Steve 將幫助我們推進策略，並使我們能夠在整個業務中實現機會。

Shifting now to the results in the third quarter.

現在轉向第三季的結果。

We delivered adjusted earnings per share of $1.09, with total revenues for the company of more than $95 billion.

我們的調整後每股收益為 1.09 美元，公司總收入超過 950 億美元。

CVS

CVS

Health has made up of three attractive operating segments, which are all critical to the health care system.

醫療保健由三個有吸引力的營運部門組成，這些部門對醫療保健系統都至關重要。

Two of those segments continue to perform consistent with our expectations.

其中兩個部門的表現持續符合我們的預期。

Our Health Services segment had another strong quarter, while delivering on our commitments to lower drug costs to our clients and members.

我們的健康服務部門又一個強勁的季度，同時兌現了我們為客戶和會員降低藥品成本的承諾。

Our pharmacy and consumer wellness business continues to be the best run national pharmacy in the country, increasing its share of scripts filled and delivering important community health access across the nation.

我們的藥房和消費者健康業務仍然是全國運營最好的國家藥房，增加了處方藥的份額，並在全國範圍內提供重要的社區健康服務。

Results in our Health Care Benefits business remained challenged as a result of continued elevated levels of utilization.

由於利用率持續升高，我們的醫療保健福利業務的表現仍面臨挑戰。

While we are clearly underperforming at HCB today, this business has incredible earnings potential and is an essential element to our strategy.

雖然我們今天 HCB 的表現顯然不佳，但這項業務具有令人難以置信的獲利潛力，並且是我們策略的重要組成部分。

We expect the elevated levels utilization will continue to pressure our 2024 performance.

我們預計利用率的提高將繼續給我們 2024 年的業績帶來壓力。

And as a result, we are not providing a formal outlook today.

因此，我們今天不提供正式的展望。

Although Tom will provide some comments on what we may expect directionally.

儘管湯姆會就我們可能期望的方向提供一些評論。

I appreciate and understand your desire for us to provide guidance at this stage, establishing credibility and earning your trust is one of my top priorities as the new leader of CVS Health.

我感謝並理解您希望我們在現階段提供指導，建立信譽並贏得您的信任是我作為 CVS Health 新領導者的首要任務之一。

I recognize that in order to achieve that, any guidance we provide should be achievable with clear opportunities for outperformance.

我認識到，為了實現這一目標，我們提供的任何指導都應該是可以實現的，並且有明顯的超越表現的機會。

This must be a core principle in order to deliver on that commitment to you, I want to spend more time understanding the complexities and challenges facing our Aetna business, and we'll provide an update when appropriate.

為了兌現對您的承諾，這必須成為核心原則，我想花更多時間了解我們 Aetna 業務面臨的複雜性和挑戰，我們將在適當的時候提供最新資訊。

There are clearly both macro and company-specific factors driving the challenges within our Aetna business.

顯然，宏觀因素和公司特定因素共同推動了我們的 Aetna 業務面臨的挑戰。

The entire industry has seen pressure, including elevated utilization coming out of the COVID-19 pandemic, and higher acuity as a result of the Medicaid redeterminations.

整個行業都面臨壓力，包括 COVID-19 大流行帶來的利用率提高，以及醫療補助重新確定帶來的更高的敏銳度。

However, I recognize that we have been more acutely impacted than others in the industry.

然而，我認識到我們比業內其他公司受到的影響更為嚴重。

As a result of our disappointing star ratings for 2024, we began the year with a known and temporary reimbursement challenge.

由於 2024 年的星級評級令人失望，我們在年初面臨已知的臨時報銷挑戰。

When we priced our Medicare Advantage business for 2024, we clearly underestimated the medical cost.

當我們為 2024 年 Medicare Advantage 業務定價時，我們顯然低估了醫療成本。

In this rising trend environment, we offered rich benefits, which exacerbated our utilization pressures and grew membership rapidly.

在這種上升趨勢的環境下，我們提供了豐富的福利，這加劇了我們的使用壓力，會員數量迅速增長。

Our individual exchange business, another area where we had a large increase in membership has seen pockets of higher utilization and several disappointing risk adjustment updates.

我們的個人交易業務是我們會員數量大幅增加的另一個領域，但利用率有所提高，但風險調整更新也令人失望。

These miscalculations during the 2023 bid processes have significantly burdened Aetna's current results.

2023 年投標過程中的這些誤算給 Aetna 目前的業績帶來了嚴重的負擔。

This performance is unacceptable.

這種表現是不可接受的。

However, I am confident in the long-term prospects of Aetna.

不過，我對安泰的長遠前景充滿信心。

We will make the hard choices and take the necessary actions to drive a multiyear earnings recovery at Aetna.

我們將做出艱難的選擇，並採取必要的行動，推動安泰保險多年的獲利復甦。

Our benefit design and price changes in Medicare Advantage and the individual exchange are down payments on this enduring commitment.

我們對 Medicare Advantage 和個人交換的福利設計和價格變化是對這一持久承諾的預付款。

We are making marked progress to realign the Aetna organization and enhance management processes.

我們在重組 Aetna 組織和增強管理流程方面取得了顯著進展。

We have taken meaningful steps to ensure the stability of the Aetna business and strengthen the leadership team.

我們採取了有意義的措施來確保 Aetna 業務的穩定性並加強領導團隊。

In addition to the appointment of Steve Nelson, we also recently added Andrea [tangelo], a seasoned Managed Care CFO to the Aetna organization.

除了任命 Steve Nelson 之外，我們最近還為 Aetna 組織增加了經驗豐富的管理式醫療財務長 Andrea [tangelo]。

Who has also been working closely with me, Tom and our Chief Operating Officer, Katrina Gerez, to help drive operational enhancements, improved forecasting and greater accountability.

他也與我、Tom 和我們的營運長 Katrina Gerez 密切合作，幫助推動營運改善、改善預測和加強問責制。

Our risk management processes have been restructured to pull underwriting and pricing authority out of the business units and into the financial chain.

我們對風險管理流程進行了重組，將核保和定價權從業務部門轉移到金融鏈。

This realignment will help improve transparency and accountability as we execute our margin recovery and drive profitable growth.

當我們執行利潤恢復和推動獲利成長時，這種調整將有助於提高透明度和問責制。

Of course, Tom and I will work closely with Steve, Katrina and [Andriana] to scrutinize and support the underwriting and pricing decisions going forward.

當然，湯姆和我將與史蒂夫、卡特里娜和[安德里亞娜]密切合作，審查和支持未來的承保和定價決策。

We've also been making operational changes, identifying and prioritizing those gaps and inefficiencies that create the most significant impacts to performance.

我們也一直在進行營運變革，確定對績效產生最重大影響的差距和低效問題並確定優先順序。

Our teams have been addressing the challenge of strained clinical operations by improving staffing and training.

我們的團隊一直在透過改善人員配備和培訓來應對緊張的臨床操作的挑戰。

We are utilizing technology to automate and streamline processes.

我們正在利用技術來自動化和簡化流程。

For example, through the power of AI, we have simplified clinical case preparation and meaningfully reduce the amount of time our care managers spend on case Prep.

例如，透過人工智慧的力量，我們簡化了臨床病例準備，並有意義地減少了護理經理花在病例準備上的時間。

We are improving our services and claim operations, increasing our accuracy and reducing abrasion for members and providers.

我們正在改進我們的服務和索賠操作，提高準確性並減少會員和提供者的磨損。

By utilizing technologies, we are driving greater insights across Aetna, including expanded integration with the Caremark team to understand and manage pharmacy spend and enhance data insights to improve our ability to rapidly identify emerging utilization trends.

透過利用技術，我們正在 Aetna 推動更深入的洞察，包括擴大與 Caremark 團隊的整合，以了解和管理藥房支出並增強數據洞察力，以提高我們快速識別新興使用趨勢的能力。

The work in Aetna is underway, and we are confident we are taking the right steps to address the underlying issues and drive improved performance with Aetna.

Aetna 的工作正在進行中，我們相信我們正在採取正確的步驟來解決根本問題並推動 Aetna 績效的提高。

Turning to our pharmacy and consumer wellness business we continue to effectively navigate a challenging and dynamic consumer backdrop.

談到我們的製藥和消費者健康業務，我們繼續有效地應對充滿挑戰和動態的消費者背景。

Our performance reflects strong execution and the benefit of strategic investments in our workflows and our colleagues.

我們的業績反映了強大的執行力以及對我們的工作流程和同事進行策略性投資的好處。

This quarter, we achieved another record high retail pharmacy script share at 27.3%, an impressive accomplishment as we continue to optimize our store footprint.

本季度，我們的零售藥局處方份額再創歷史新高，達到 27.3%，這是我們繼續優化門市佈局的一項令人印象深刻的成就。

By the end of November, we will have completed our previously announced 3-year store optimization initiative targeting 900 stores and expect to close approximately 270 stores in 2025.

到 11 月底，我們將完成先前宣布的 3 年門市優化計劃，目標是 900 家門市，並預計在 2025 年關閉約 270 家門市。

We recognize the importance of retail pharmacy and the communities we serve and will continue to be thoughtful and deliberate as we execute on our footprint optimization efforts.

我們認識到零售藥局和我們所服務的社區的重要性，並將在執行足跡優化工作時繼續深思熟慮和深思熟慮。

We are progressing our transition to the CVS cost manage model and have reached agreements covering more than half of our total commercial scripts.

我們正在推進向 CVS 成本管理模式的過渡，並已達成涵蓋一半以上商業腳本的協議。

The ongoing discussions with our large PBM partners remain active and constructive as we move forward with the full commercial contract implementation on January '25.

隨著我們於 25 月 25 日全面實施商業合同，與我們的大型 PBM 合作夥伴正在進行的討論仍然活躍且富有建設性。

We have also been deliberate in enhancing the durability and strength of our store operations to ensure we consistently serve our role as a community health destination.

我們也刻意增強商店營運的持久性和實力，以確保我們始終如一地發揮作為社區健康目的地的作用。

This was clear on the aftermath of the recent hurricanes.

這在最近的颶風後果中表現得很明顯。

Our colleagues were instrumental in ensuring our operations were back online quickly with most stores open within 48 hours.

我們的同事在確保我們的營運快速恢復正常方面發揮了重要作用，大多數商店都在 48 小時內開業。

We utilized our dynamic approach to workload sharing capability used across most of our fleet, allowing us to rapidly recover impacted stores, ensure patient access to critical medications and provide continuity of care for our customers.

我們利用動態方法來實現我們大多數車隊使用的工作負載共享功能，使我們能夠快速恢復受影響的商店，確保患者獲得關鍵藥物，並為我們的客戶提供連續性護理。

In our Pharmacy Services business, we had another very strong quarter, delivering on our commitments to our clients and customers.

在我們的藥局服務業務中，我們又度過了一個非常強勁的季度，兌現了我們對客戶和消費者的承諾。

In spite of the intense scrutiny and rhetoric at Caremark and the PBM industry base, we continue to play a crucial role in managing drug costs in this country.

儘管 Caremark 和 PBM 產業基地面臨嚴格的審查和言論，我們仍然在管理這個國家的藥物成本方面發揮著至關重要的作用。

I've highlighted the progress we made on the biosimilar space and our customers continue to see the value that we're delivering with our capabilities.

我強調了我們在生物相似藥領域的進展，我們的客戶繼續看到我們透過我們的能力提供的價值。

We are once again positioned to close out a robust selling season, achieving a retention rate in the high 90s.

我們再次準備好結束強勁的銷售季節，實現 90 多歲的保留率。

We continue to offer our clients choice and innovation and our true cost offering is resonating in the market.

我們繼續為客戶提供選擇和創新，我們真正的成本產品在市場上引起共鳴。

For 2025, clients representing 70% of our commercial lives have chosen to implement multiple elements of the TruCost model into their benefit design options.

到 2025 年，占我們商業生活 70% 的客戶選擇將 TruCost 模型的多個要素實施到他們的福利設計選項中。

And finally, our health care delivery business, we continue to progress our strategy of delivering superior care to the patients we serve.

最後，在我們的醫療保健服務業務方面，我們繼續推動為我們服務的患者提供優質護理的策略。

Signify delivered another strong quarter.

Signify 再次實現強勁的季度業績。

Aetna members served by Signify have nearly doubled compared to last year, supported by our ability to utilize touch points across CVS Health.

由於我們在 CVS Health 中利用接觸點的能力，由 Signify 服務的 Aetna 會員數量比去年增加了近一倍。

Our enterprise connections also continued to accelerate patient growth at Oak Street our at-risk membership is up 32% from the same quarter last year, and the number of Aetna members enrolled at Oak Street has approximately quadrupled since the close of the acquisition.

我們的企業聯繫也持續加速橡樹街的患者成長，我們的風險會員人數比去年同期增加了 32%，自收購結束以來，在橡樹街註冊的 Aetna 會員數量增加了四倍。

Through thoughtful benefit design, we continue to introduce Aetna members to high-quality providers like Oak Street Health, allowing us to improve member experiences and deliver better health outcomes.

透過深思熟慮的福利設計，我們持續向 Aetna 會員介紹 Oak Street Health 等優質提供者，使我們能夠改善會員體驗並提供更好的健康結果。

As we look ahead to 2025 and beyond, there are reasons to be optimistic, and I'm excited about our path forward.

展望 2025 年及以後，我們有理由保持樂觀，我對我們的前進道路感到興奮。

We have implemented a disciplined approach to Medicare Advantage benefit design.

我們對 Medicare Advantage 福利設計實施了嚴格的方法。

We continue to accelerate progress on our innovative pharmacy models and biosimilar strategy.

我們持續加快創新藥房模式和生物相似藥策略的進展。

We've delivered wins in both Caremark and at the selling season and we are rapidly advancing the integration of our health care delivery assets.

我們在 Caremark 和銷售季節都取得了勝利，我們正在快速推進醫療保健服務資產的整合。

We are making the necessary changes to return our business to profitable growth in 2025.

我們正在做出必要的改變，以便我們的業務在 2025 年恢復獲利成長。

We are committed to a disciplined financial policy and with improved profitability, we expect to strengthen our balance sheet.

我們致力於實行嚴格的財務政策，隨著獲利能力的提高，我們預計將加強我們的資產負債表。

We have strong leadership across the country.

我們在全國範圍內擁有強而有力的領導。

We have a powerful collection of businesses operating in some of the most critical areas of health care, which provide us with a unique opportunity to deliver value for our customers, colleagues and shareholders.

我們在醫療保健的一些最關鍵領域擁有眾多強大的企業，這為我們提供了獨特的機會，為我們的客戶、同事和股東創造價值。

I also want to extend our appreciation to our over 300,000 colleagues.

我還要向超過 30 萬名同事表示感謝。

I'm grateful for your continued dedication, for our collaboration to drive continuous improvement, and for all that you do every single day for the millions of customers and members we serve.

我感謝您持續的奉獻，感謝我們的合作推動持續改進，感謝您每天為我們服務的數百萬客戶和會員所做的一切。

With that, I'll pass the call over to Tom.

這樣，我會將電話轉給湯姆。

Tom?

湯姆？

Thank you, David, and thanks to everyone for joining us this morning.

謝謝大衛，也謝謝大家今天早上加入我們。

I'll start with a few highlights on total company performance.

我將首先介紹公司整體業績的一些亮點。

Third quarter revenues were approximately $95.4 billion, an increase of approximately 6% over the prior year quarter, primarily reflecting growth in our health care benefits and pharmacy and consumer wellness segments.

第三季營收約 954 億美元，比去年同期成長約 6%，主要反映了我們的醫療保健福利以及藥品和消費者健康領域的成長。

We delivered adjusted operating income of approximately $2.5 billion, and adjusted EPS of $1.09.

我們的調整後營業收入約為 25 億美元，調整後每股收益為 1.09 美元。

Year-to-date cash flow from operations were approximately $7.2 billion, a lower result as compared to the same period last year, primarily due to the timing of CMS receipts and the impact of higher utilization on HCV earnings.

年初至今的營運現金流量約為 72 億美元，低於去年同期，主要是由於 CMS 收款時間以及較高使用率對 HCV 收入的影響。

Let's look at the performance in each of our segments.

讓我們看看每個細分市場的表現。

In our Health Care Benefits segment, we grew revenues to approximately $33 billion, an increase of over 25% year-over-year, reflecting growth in all lines of business.

在醫療保健福利部門，我們的收入成長至約 330 億美元，年成長超過 25%，反映了所有業務線的成長。

Medical membership grew to approximately $27.1 million, an increase of 178,000 members sequentially, primarily reflecting growth in Medicare and individual exchange.

醫療會員人數成長至約 2,710 萬美元，會員人數連續增加 178,000 名，主要反映了醫療保險和個人交換的成長。

During the quarter, the segment generated an adjusted operating loss of $924 million.

本季度，該部門調整後營運虧損為 9.24 億美元。

This result includes the impact of premium deficiency reserves of approximately $1.1 billion recorded primarily in our Medicare and individual exchange businesses.

這一結果包括主要記錄在我們的醫療保險和個人兌換業務中的約 11 億美元保費不足準備金的影響。

As a reminder, PDRs generally measure variable losses in a product and do not contemplate fixed expenses.

提醒一下，PDR 通常衡量產品的可變損失，而不考慮固定費用。

The aggregate of the PDRs was comprised of approximately $670 million of health care costs. and $394 million of operating expenses, specifically related to the write-off of unamortized deferred acquisition costs.

PDR 總計包括約 6.7 億美元的醫療保健費用。 3.94 億美元的營運費用，特別是與未攤銷遞延購置成本的沖銷有關。

Substantially, all of the charges were associated with the 2024 policy, shifting the earnings cadence between the third and fourth quarters.

基本上，所有費用都與 2024 年政策相關，改變了第三季和第四季的獲利節奏。

Our medical benefit ratio of 95.2% increased 950 basis points from the prior year quarter including a 220 basis points impact from the PDRs.

我們的醫療福利率為 95.2%，比去年同期增加了 950 個基點，其中 PDR 的影響增加了 220 個基點。

This increase was primarily driven by higher utilization, higher acuity in Medicaid, the premium impact of lower Stars ratings for payment year 2024 and an update to our 2024 individual exchange risk adjustment accrual.

這一增長主要是由於利用率更高、醫療補助的敏銳度更高、2024 年付款年星級評級較低的保費影響以及我們 2024 年個人外匯風險調整應計費用的更新。

Medical costs remain elevated in our Medicare book and at levels above what was contemplated in our previous guidance.

我們的醫療保險手冊中的醫療費用仍然很高，並且高於我們先前指導中預期的水平。

Pressure is largely attributable to the same categories we discussed last quarter, including inpatient, outpatient, supplemental benefits and pharmacy.

壓力主要歸因於我們上季度討論的相同類別，包括住院、門診、補充福利和藥房。

During the third quarter, we also saw unfavorable development of 2024 medical costs, primarily related to second quarter dates of service, which has adversely impacted our trend outlook for the remainder of the year.

在第三季度，我們也看到 2024 年醫療成本的不利發展，主要與第二季度的服務日期有關，這對我們今年剩餘時間的趨勢前景產生了不利影響。

Medical costs in our individual exchange business also accelerated during the quarter with broad levels of higher utilization above our prior expectations.

本季我們個人兌換業務的醫療成本也有所增加，利用率普遍高於我們先前的預期。

The pressure we've experienced thus far has been primarily driven by certain high-cost geographies where the combination of our growth and [metal] tier mix have led to higher medical costs.

到目前為止，我們所經歷的壓力主要是由某些高成本地區造成的，在這些地區，我們的成長和[金屬]層組合的結合導致了更高的醫療成本。

During the third quarter, we also received updated risk adjustment data for our individual exchange business.

第三季度，我們也收到了個人交易所業務的最新風險調整數據。

As a result, we increased our risk adjustment accrual for the 2024 plan year by approximately $275 million in the quarter.

因此，我們在本季將 2024 年計畫年度的風險調整應計額增加了約 2.75 億美元。

We will continue to evaluate our revenue accruals for potential additional pressure as we receive updated data on our risk scores later this year and into early 2025.

隨著我們在今年稍後和 2025 年初收到風險評分的更新數據，我們將繼續評估應計收入是否有潛在的額外壓力。

In our Medicaid business, consistent with others in the industry, we continue to experience higher acuity related to the impact of redeterminations.

在我們的醫療補助業務中，與業內其他公司一樣，我們繼續對重新決定的影響有更高的敏銳度。

We believe the level of dislocation between acuity and rates stabilized towards the end of the third quarter.

我們認為，敏銳度和利率之間的錯位水準在第三季末趨於穩定。

We continue to work closely with our state partners to align the rates with changes in acuity.

我們繼續與我們的州合作夥伴密切合作，使費率與敏銳度的變化保持一致。

Although the engagement with our state partners has been constructive, we have seen some rate updates in the second half of 2024, they remain inadequate to cover current levels of elevated acuity.

儘管與我們的州合作夥伴的接觸是建設性的，但我們在 2024 年下半年看到了一些費率更新，但它們仍然不足以覆蓋當前提高的敏銳度水平。

In light of the utilization pressures we have seen across the Health Care Benefits segment in 2024, we continue to closely watch our group commercial business.

鑑於 2024 年我們在醫療保健福利領域看到的利用壓力，我們將繼續密切關注我們的集團商業業務。

To date, pressures in this business have largely been manageable.

迄今為止，該業務的壓力基本上是可控的。

We have proactively pushed rate to cover emerging medical cost trends.

我們積極提高費率以涵蓋新興的醫療費用趨勢。

This will result in lower commercial risk membership in 2025, hindering our ability to grow earnings in this business.

這將導致 2025 年會員商業風險降低，從而阻礙我們增加該業務收入的能力。

Days claims payable at the end of the quarter was 44.6 days, up 1.5 days sequentially, primarily driven by the impact of the premium deficiency reserves. [DCP] was down 5.7 days from the prior year quarter, primarily driven by growth in our Medicare business and the impact of increased pharmacy trends.

本季末應付理賠天數為 44.6 天，比上一季增加 1.5 天，主要是由於保費不足準備金的影響。 [DCP] 比去年同期減少了 5.7 天，這主要是由於我們的醫療保險業務的成長以及藥品趨勢增加的影響。

We remain confident in the adequacy of our reserves.

我們對儲備充足性仍然充滿信心。

Our Health Services segment delivered another strong quarter.

我們的健康服務部門再次實現強勁的季度業績。

We generated revenue of $44.1 billion during the quarter, a decrease of approximately 6% year-over-year, primarily driven by the previously announced loss of a large client and continued pharmacy client price improvements.

本季我們的營收為 441 億美元，年減約 6%，這主要是由於先前宣布的大客戶流失以及藥房客戶價格持續上漲所致。

These decreases were partially offset by pharmacy drug mix, increased contributions from our health care delivery assets and growth in specialty pharmacy.

這些下降被藥房藥物組合、我們的醫療保健服務資產貢獻增加以及專業藥房的成長部分抵消。

Adjusted operating income of approximately $2.2 billion increased 17% from the prior year quarter, reflecting improved purchasing economics, partially offset by continued pharmacy client price improvements and the previously announced loss of a large client.

調整後營業收入約為 22 億美元，較去年同期成長 17%，反映出採購經濟性的改善，但部分被持續的藥房客戶價格上漲和先前宣布的大客戶流失所抵消。

Total pharmacy claims processed in the quarter were approximately $484 million in total Pharmacy Services membership as of the end of the quarter was approximately $90 million.

本季處理的藥房索賠總額約為 4.84 億美元，截至本季末，藥房服務會員總數約為 9,000 萬美元。

We continue to be encouraged by the growth of our health care delivery assets.

我們的醫療保健服務資產的成長繼續令我們感到鼓舞。

As David mentioned, Signify continued its strong performance in the quarter, generating revenue growth of approximately 37% over the prior year quarter.

正如 David 所提到的，Signify 在本季持續保持強勁表現，營收比去年同期成長約 37%。

Oak Street revenue increased significantly in the quarter, growing approximately 36%, driven by strong membership growth.

在會員強勁成長的推動下，Oak Street 營收在本季大幅成長，成長約 36%。

At risk members increased by approximately 32% compared to the same quarter last year, supported by our ability to use touch points across CVS Health.

由於我們在整個 CVS Health 中使用接觸點的能力，處於風險中的會員數量與去年同期相比增加了約 32%。

We are encouraged by Oak Street's performance in this challenging environment.

我們對橡樹街在這個充滿挑戰的環境中的表現感到鼓舞。

During the quarter, our Pharmacy and Consumer Wellness segment generated revenue of approximately $32.4 billion, an increase of over 12% versus the prior year and over 15% on a same-store basis.

本季度，我們的藥房和消費者健康部門創造了約 324 億美元的收入，比上年增長超過 12%，同店增長超過 15%。

Adjusted operating income of nearly $1.6 billion increased approximately 15% versus the prior year, driven by increased prescription volume, including increased contributions from vaccines and improved drug purchasing partially offset by continued pharmacy reimbursement pressure and lower front store volumes.

調整後的營業收入接近16 億美元，較上年增長約15%，這主要得益於處方量的增加，其中包括疫苗貢獻的增加和藥品採購的改善，但部分被持續的藥房報銷壓力和較低的前店銷量所抵銷。

Same-store pharmacy sales in the quarter increased by nearly 20% versus the prior year and same-store prescription volumes increased by approximately 9%.

本季同店藥局銷售額較前一年成長近 20%，同店處方藥量成長約 9%。

As David mentioned, we continue to grow our retail pharmacy script share position, achieving a share of approximately 27.3%.

正如 David 所提到的，我們繼續擴大零售藥房處方份額，實現約 27.3% 的份額。

Same-store, front store sales were down approximately 1% versus the same quarter last year.

同店、前店銷售額與去年同期相比下降了約 1%。

One other item I would like to highlight for investors is that we took a restructuring charge of nearly $1.2 billion in the quarter.

我想向投資者強調的另一件事是，我們在本季承擔了近 12 億美元的重組費用。

This amount reflects several components, including impairment charges for approximately 270 stores we expect to close in 2025, costs related to the discontinuation of non-core businesses and costs associated with workforce optimization.

這筆金額反映了幾個組成部分，包括我們預計在 2025 年關閉的約 270 家商店的減損費用、與非核心業務終止相關的成本以及與勞動力優化相關的成本。

Shifting now to cash flow and the balance sheet.

現在轉向現金流和資產負債表。

For our third quarter, we generated year-to-date cash flow from operations of approximately $7.2 billion.

第三季度，我們年初至今的營運現金流約為 72 億美元。

During the quarter, we returned $837 million to shareholders through our quarterly dividend, and we ended the quarter with approximately $1.2 billion of cash at the parent and unrestricted subsidiaries.

本季度，我們透過季度股息向股東返還 8.37 億美元，本季結束時，我們在母公司和不受限制的子公司中擁有約 12 億美元的現金。

Our leverage ratio at the end of the quarter was approximately 4.6 times, which is above our long-term target.

截至本季末，我們的槓桿率約為 4.6 倍，高於我們的長期目標。

We remain committed to maintaining our current investment-grade ratings and expect our leverage to return to more normalized levels as we execute on margin recovery in the Aetna business.

我們仍然致力於維持目前的投資等級評級，並預計隨著我們在 Aetna 業務中執行利潤恢復，我們的槓桿率將恢復到更正常的水平。

As David mentioned, we are not providing a formal outlook for 2024 at this stage.

正如 David 所提到的，我們現階段並未提供 2024 年的正式展望。

However, we would like to provide some directional commentary to help you better understand how we see the moving parts.

但是，我們希望提供一些方向性評論，以幫助您更好地了解我們如何看待移動部件。

Starting with our health services and pharmacy and consumer wellness segments.

從我們的健康服務、藥局和消費者健康領域開始。

As we have previously highlighted, those businesses continue to deliver strong results.

正如我們之前強調的那樣，這些業務繼續取得強勁業績。

In PCW, while the immunization season got off to a stronger start than we expected, shifting demand into the third quarter, strong script growth continues to give us confidence in the previous outlook we shared with investors.

在 PCW 中，雖然免疫季節的開局比我們預期的要好，將需求轉移到第三季度，但強勁的處方增長繼續讓我們對先前與投資者分享的前景充滿信心。

In the Health Services segment, Caremark's earnings progression in 2024 started slow, but steadily built momentum over the second and third quarters.

在健康服務領域，Caremark 2024 年的獲利進展緩慢，但在第二季和第三季穩定成長。

While we maintain a cautious outlook on our health care delivery business as we evaluate the potential for additional Medicare trend-related risks, we remain confident in our ability to deliver on the Health Services segment earnings outlook we shared with investors on our second quarter call.

雖然我們在評估與醫療保險趨勢相關的額外風險的潛力時對醫療保健服務業務保持謹慎的前景，但我們仍然對我們在第二季度電話會議上與投資者分享的醫療服務部門盈利前景的能力充滿信心。

Within health care benefits, we continue to grapple with both environmental and company-specific challenges as you have seen with our third quarter results.

在醫療保健福利方面，我們繼續應對環境和公司特定的挑戰，正如您從我們第三季的業績中看到的那樣。

Similar to others within the industry, Medicare Advantage utilization continues to be elevated.

與業內其他公司類似，Medicare Advantage 的利用率持續上升。

We have also grown membership very rapidly with a very rich benefit offering, which has resulted in benefit induced utilization.

我們也透過非常豐富的福利產品迅速增加了會員數量，這導致了福利誘導的利用。

Medicaid continues to be pressured by the dislocation between acuity and rates as well as seeing some pockets of higher utilization.

醫療補助繼續受到敏銳度和費率之間的錯位以及一些利用率較高的壓力。

We have also seen rapid growth in our individual exchange business, which has led to several disappointing updates on risk-adjusted revenue and in some states, higher-than-expected utilization.

我們還看到我們的個人交易所業務快速成長，這導致風險調整後收入的幾次令人失望的更新，並且在某些州，利用率高於預期。

To date, the combination of these factors has challenged our visibility and our 2024 outlook.

迄今為止，這些因素的結合對我們的能見度和 2024 年前景提出了挑戰。

While we are not providing formal guidance today, let me walk you through one potential scenario.

雖然我們今天不提供正式指導，但讓我帶您了解一個可能的情況。

If trends develop unfavorably and persist that the significant levels we have experienced in recent months, our fourth quarter reported MBR could increase by over 700 basis points as compared to the fourth quarter of 2023.

如果趨勢發展不利，並且持續保持我們近幾個月所經歷的顯著水平，我們第四季度報告的 MBR 可能會比 2023 年第四季增加 700 個基點以上。

Additionally, in this scenario, we would likely need to take a PDR in our group Medicare Advantage business related to 2025 dates of service, which would further pressure 2024 results.

此外，在這種情況下，我們可能需要在集團 Medicare Advantage 業務中進行與 2025 年服務日期相關的 PDR，這將進一步給 2024 年業績帶來壓力。

Despite challenges in 2024, we have taken deliberate actions that position us for growth in 2025 and beyond.

儘管 2024 年面臨挑戰，但我們已採取審慎行動，為 2025 年及以後的成長做好準備。

While we will not give formal 2025 guidance until next year when we have better visibility on our 2024 medical cost baseline and our changing membership, I want to provide an update on some of the key headwinds and tailwinds.

雖然我們要到明年才能更了解 2024 年醫療成本基準和不斷變化的會員資格，才會給出正式的 2025 年指導，但我想提供一些主要不利因素和有利因素的最新情況。

Starting first with the headwinds.

首先從逆風開始。

In our PCW segment, we expect earnings to decline in line with our long-term guidance framework.

在我們的 PCW 部門，我們預計收益將根據我們的長期指導框架下降。

As David mentioned, we are encouraged by the adoption of CVS cost vintage and the shift of commercial scripts to this model on January 1.

正如 David 所提到的，我們對 CVS 成本復古的採用以及 1 月 1 日商業腳本向此模型的轉變感到鼓舞。

We expect 2025 to be a transition year that positions us for outperformance of our long-term growth target in future years.

我們預計 2025 年將是一個過渡年，使我們能夠在未來幾年超越我們的長期成長目標。

We also remain cautious in our outlook for front store sales, which have been pressured in recent quarters, consistent with the broader macroeconomic backdrop.

我們對前店銷售的前景也保持謹慎態度，近幾個季度前店銷售受到壓力，這與更廣泛的宏觀經濟背景一致。

As we previously discussed, we expect the return of certain variable corporate expenses.

正如我們之前討論的，我們預期某些可變企業費用會得到回報。

We also expect higher interest as we annualize the expense from our May 2024 financing, a decline in net investment income and modest dilution from the increase in our share count.

我們也預期利息會上漲，因為我們將 2024 年 5 月融資的費用年化、淨投資收入下降以及股份數量增加帶來的適度稀釋。

Shifting now to the tailwinds.

現在轉向順風。

We expect improvement in contributions from our Health Care Benefits segment.

我們預計醫療保健福利部門的貢獻將有所改善。

We believe our deliberate approach to our 2025 Medicare Advantage bids and our focused changes to our footprint, which we expect to result in membership disenrollment of 5% to 10% when combined with our improved Star ratings, will result in margin recovery.

我們相信，我們對2025 年Medicare Advantage 投標的深思熟慮的方法以及我們對足跡的重點改變（我們預計，與我們改進的星級評級相結合，將導致5% 至10% 的會員退出）將導致利潤率恢復。

This is a significant first step on our journey back to target margins of 3% to 5%.

這是我們回歸 3% 至 5% 目標利潤率的重要第一步。

We continue to view the dislocation between Acuity and rates in Medicaid as temporary and expect this to be resolved over subsequent pricing cycles.

我們仍然認為 Acuity 和醫療補助費率之間的錯位是暫時的，並預計這一問題將在後續定價週期中解決。

However, we do not expect the dislocation to be fully resolved before the end of 2025.

然而，我們預計這種錯位不會在 2025 年底前完全解決。

We expect improvement in our individual exchange business as a result of our pricing actions and deliberate product repositioning, which we project will decrease membership in this block of business in 2025.

我們預計，由於我們的定價行動和深思熟慮的產品重新定位，我們的個人交易所業務將得到改善，我們預計這將在 2025 年減少該業務領域的會員數量。

We will continue to refine our product offerings for long-term sustainability.

我們將繼續完善我們的產品，以實現長期可持續發展。

We also expect underlying growth in our Health Services business, including growth in pharmacy services as we continue to drive value for our clients and incremental improvement in our health care delivery businesses.

我們也預期我們的健康服務業務將實現潛在成長，包括藥局服務的成長，因為我們將繼續為客戶創造價值，並逐步改善我們的醫療保健服務業務。

We expect our initial outlook for this segment will be below our long-term growth framework, but will prudently provide opportunities for upside over the course of the year.

我們預計該領域的初步前景將低於我們的長期成長框架，但將謹慎地在今年提供上行機會。

Finally, we have executed the first step of our multiyear cost savings initiative that we expect will generate over $500 million next year, helping to offset the return of variable expense in 2025.

最後，我們已經執行了多年成本節約計畫的第一步，預計明年將產生超過 5 億美元的收入，有助於抵消 2025 年可變費用的回報。

Taking a step back, 2024 has been a disappointing year for performance in our Health Care Benefits segment.

退一步來說，2024 年是我們醫療保健福利領域表現令人失望的一年。

We could experience mid-single-digit percentage losses in our Medicare business.

我們的醫療保險業務可能會出現中個位數百分比的損失。

Our foray into the individual exchange business could result in negative margins that approach double digits.

我們進軍個人兌換業務可能會導致接近兩位數的負利潤。

We are also projecting modest negative margins in our Medicaid business.

我們也預期醫療補助業務的利潤率將出現小幅負值。

It is possible that our health care benefits business could show operating losses in 2024 after generating over $5.5 billion of adjusted operating income in 2023.

我們的醫療保健福利業務在 2023 年產生超過 55 億美元的調整後營業收入後，到 2024 年可能會出現營業虧損。

Conversely, this means that there are well over $3 of embedded adjusted EPS and if we could return Aetna profitability to 2023 levels.

相反，這意味著如果我們能夠將 Aetna 的獲利能力恢復到 2023 年的水平，則嵌入調整後每股收益將遠遠超過 3 美元。

Open enrollment for both Medicare Advantage and individual exchange has demonstrated that we took meaningful action in curtailing benefits, adjusting products and where appropriate, raising prices.

Medicare Advantage 和個人交換的公開註冊表明，我們在削減福利、調整產品以及在適當情況下提高價格方面採取了有意義的行動。

While we are confident we have taken the right initial actions, the road to recovery will take time.

儘管我們有信心採取了正確的初步行動，但復甦之路仍需要時間。

We look forward to providing more details on our 2025 outlook and those first steps on our journey we have more clarity on the moving parts in our Health Care Benefits business next year.

我們期待提供有關 2025 年展望的更多詳細信息，以及我們旅程中的第一步，我們對明年醫療保健福利業務的動態部分有更清晰的了解。

With that, we will now open the call to your questions.

現在，我們將開始回答您的問題。

Operator?

操作員？

(Operator Instructions)

（操作員說明）

Lisa Gill, JPMorgan.

麗莎·吉爾，摩根大通。

Great.

偉大的。

Thanks very much.

非常感謝。

And thanks for the detail.

感謝您提供詳細資訊。

Tom, I just wanted to make sure that I understand a couple of things.

湯姆，我只是想確保我理解一些事情。

One, when I think about the MA bids that you put in for 2025, you talked about, and we also on the plan finder, the cuts.

第一，當我想到您為 2025 年提出的 MA 出價時，您談到了削減，我們也在計劃查找器上談到了削減。

Can you maybe just talk about -- I know we're only one month in, but you seeing the disenrollment that you expected?

你能不能談談——我知道我們才一個月，但你看到了你所期望的退學情況？

And two, just given the size of the surprise that we've seen here in the back half of the year, the level of confidence that you have around the bids that you did put in for 2025, if I can understand that.

第二，考慮到我們在今年下半年看到的驚喜有多大，以及你們對 2025 年投標的信心程度（如果我能理解的話）。

And then just secondly, you talked about pharmacy.

其次，你談到了藥局。

We've heard others talk about pharmacy trends here in the back half of the year, really shifting and changing because of the inflation Reduction Act and changes around catastrophic coverage.

我們聽到其他人談論今年下半年的藥物趨勢，由於通貨膨脹削減法案和災難性保險的變化，這些趨勢確實發生了變化。

Just curious, one, did you see that as well specific to those changes?

只是好奇，第一，您是否也看到了這些具體的改變？

And is it benefiting perhaps some of the other sides of your business?

它是否有利於您業務的其他方面？

I know obviously, you have a really big specialty business, and you talked about the strength in the pharmacy business.

我顯然知道，您擁有非常大的專業業務，並且您談到了製藥業務的實力。

Let me start with your first question.

讓我從你的第一個問題開始。

So -- we're early in the open enrollment season, but I did reiterate the guidance that we've been giving for a couple of months now.

因此，我們正處於公開招生季節的早期，但我確實重申了我們幾個月來一直提供的指導。

Our early indicators would suggest that we would be down in that 5% to 10% range on the total book.

我們的早期指標表明，我們的總帳面價值將下降 5% 到 10%。

We'll have more stability on the group book, so that's a higher percentage is think about the individual and the dual eligible populations that we'll see declines on.

我們的團體名冊將更加穩定，因此考慮到個人和雙重合格人群，我們將看到下降的比例更高。

But we feel reasonably good about how the membership is coming in and that it would be within that range that we've been guiding investors to.

但我們對會員的加入情況感到相當滿意，並且它會在我們一直引導投資者的範圍內。

As you think about ability and confidence in the bids, the bids are clearly designed to improve results next year.

當您考慮投標的能力和信心時，投標顯然是為了改善明年的結果而設計的。

And maybe there's a couple of things I can talk you through at a high level, just to give you a framework to think about that.

也許我可以在高層次上向您介紹一些事情，只是為了給您一個思考的框架。

The first is improvement in

首先是改進

[stars].

[星]。

And so because of the contracts that we have that are now going to be 4 stars or better for 2025 payment year, that's going to be about an $800 million headwind no matter what the baseline is -- tailwind I keep doing that.

因此，由於我們現在擁有的合約在 2025 年付款年將達到 4 星或更好，因此無論基線是什麼，這都將帶來約 8 億美元的逆風——順風我會繼續這樣做。

It used to be a headwind, and now it's going to be a tailwind next year.

過去是逆風，現在明年將是順風。

The -- on the individual blocks of business, we have made deliberate benefit design changes to supplemental benefits which will fundamentally change how these benefits function in 2025, which will also improve margins.

在各個業務領域，我們對補充福利進行了有意的福利設計變更，這將從根本上改變這些福利在 2025 年的運作方式，這也將提高利潤率。

Finally, we've both exited underperforming counties and we pulled underperforming products that will impact nearly 0.5 million members.

最後，我們都退出了表現不佳的縣，並撤出了表現不佳的產品，這將影響近 50 萬名會員。

Those changes should also improve profitability in '25 as many of those members will choose newly designed products that will have an improved margin profile.

這些變化也應該會提高 25 年的獲利能力，因為許多會員將選擇新設計的產品，這些產品的利潤率將會得到改善。

We expect that those changes are going to drive margin expansion.

我們預計這些變化將推動利潤率擴張。

And when we have a better understanding of what that membership mix looks like for 2025 as well as our '24 baseline, we'll be able to better provide specifics on the level of anticipated improvement next year.

當我們更了解 2025 年的會員組合以及我們的 24 個基準時，我們將能夠更好地提供明年預期改進水平的具體資訊。

Yes.

是的。

Lisa, this is David.

麗莎，這是大衛。

Maybe just one additional follow-on here.

也許這裡只是一個額外的後續。

I think one is we are feeling very good about the improvements that we've made going into '25.

我認為其中之一是我們對進入 25 年所做的改進感覺非常好。

So the recognizing, obviously, the challenge in '24, we had -- we believe we made the appropriate course correction.

因此，顯然，我們認識到 24 年面臨的挑戰，我們相信我們做出了適當的路線修正。

And then as it relates to pharmacy, which was your last question, I think this is the unique opportunity of this enterprise.

然後，由於它與製藥有關，這是您的最後一個問題，我認為這是該企業的獨特機會。

We -- the goal here is not to be surprised especially as it relates to pharmacy costs.

我們的目標並不令人驚訝，特別是因為它與藥品成本有關。

We think we've anticipated and contemplated the changes both at ROA as well as the broader macro trends that we see within pharmacy.

我們認為我們已經預期並考慮了 ROA 的變化以及我們在製藥業看到的更廣泛的宏觀趨勢。

And the goal here, especially now with the addition of both Steve and Prem we're going to see further integration of not just the pharmacy benefit integration, but more importantly, the medical pharmacy, which is a piece that obviously, I think, is driving some of the increased costs in the back of the year.

這裡的目標，特別是現在隨著 Steve 和 Prem 的加入，我們將看到進一步的整合，不僅是藥房福利整合，更重要的是醫療藥房，我認為這顯然是一個部分導致今年下半年成本增加。

(Operator Instructions)

（操作員說明）

Justin Lake, Wolfe Research.

賈斯汀·萊克，沃爾夫研究中心。

Thanks.

謝謝。

Good morning.

早安.

First, just wanted to clarify the 4Q commentary, Tom, that you said is potentially up 700 basis points or I'm getting to about 95.5% [similar].

首先，我想澄清一下第四季的評論，湯姆，你說可能會上漲 700 個基點，或者我的漲幅約為 95.5% [類似]。

Does that include the 3Q PDR and the potential Medicare Advantage PDR you mentioned?

這是否包括您提到的 3Q PDR 和潛在的 Medicare Advantage PDR？

And then more importantly, how should we think about framing 2024 run rate earnings into 2025.

更重要的是，我們應該如何考慮將 2024 年的運行率收益納入 2025 年。

Trying to understand your MLR looks like it's obviously a lot higher in the third quarter and going to be a lot higher in the fourth quarter. do we need to run rate that back into the first half?

試著了解您的 MLR 看起來第三季明顯要高得多，並且第四季度也會高得多。我們需要將這種速度帶回上半場嗎？

So let's just say, $0.75 of earnings kind of decline?

這麼說吧，收益下降了 0.75 美元？

Just trying to understand the run rate versus -- you're going to report a number for 2024, but what's the real run rate that we jump off of into 2025?

只是想了解運行率與 - 您將報告 2024 年的數字，但我們跳到 2025 年的實際運行率是多少？

Is there a framework to think about that?

有沒有一個框架可以思考這個問題？

Thanks.

謝謝。

Yes, just let me touch on some of your other questions first.

是的，讓我先談談你的其他一些問題。

But I think part of the question that we need to answer and that I think you need to ask yourself is how much of this benefit and with this trend that we're seeing is because of the benefits that we put out into the market and what kind of utilization is being induced because of that?

但我認為我們需要回答的問題的一部分，我認為你需要問自己的是，我們看到的這種好處和這種趨勢有多少是因為我們投入市場的好處以及什麼因此正在引發某種利用？

What kind of membership did we attract -- and how much will that profile change with the changing benefits next year.

我們吸引了什麼樣的會員——隨著明年的福利變化，這種形象會發生多大的變化。

And that's part of the open question to your -- the opening question in answering your question that I think we want to take a little bit more time to understand.

這是回答你的問題的開放問題的一部分，我認為我們需要多花一點時間來理解。

But -- on your MLR specific comments, that is inclusive of the release of the PDR that you could see that 700 basis points increase, but not necessarily inclusive of a PDR and group, which will depend on a variety of factors.

但是，根據國土資源部的具體評論，這包括 PDR 的發布，您可以看到增加了 700 個基點，但不一定包括 PDR 和團體，這將取決於多種因素。

.

。

But let me walk you through -- give you a little bit more commentary and color on what we outlined here.

但讓我帶您了解一下——對我們在此概述的內容提供更多評論和色彩。

First, I think it's important to just continue to reiterate we feel very good about our ability to achieve the guidance we gave last quarter on both the PCW and the Health Services segments.

首先，我認為重要的是繼續重申，我們對實現上季度 PCW 和醫療服務領域指導的能力感到非常滿意。

So the open question here is health care benefits.

因此，這裡的懸而未決的問題是醫療保健福利。

For our larger lines of business, second quarter trend appears to be the high point, but the third quarter dates of service are still immature.

對於我們較大的業務線來說，第二季的趨勢似乎是高點，但第三季的服務日期仍然不成熟。

So there are three components to the scenario that we laid out.

因此，我們提出的場景由三個組成部分組成。

First, across all of our major business lines, we assume that third quarter trends would develop unfavorably, moving them to the highest levels we've seen over the last few months and then assuming that they persisted at those levels throughout the fourth quarter.

首先，在我們所有的主要業務領域，我們假設第三季度的趨勢將不利地發展，將其推至過去幾個月我們所看到的最高水平，然後假設它們在整個第四季度持續保持在這些水平。

Second, we assume we saw further deterioration in our risk adjustment accruals on our individual exchange business in the fourth quarter, call it an additional point on gross revenue.

其次，我們假設我們看到第四季度個人交易所業務的風險調整應計費用進一步惡化，稱其為總收入的一個額外點。

Third, we made a provision that there could be some modest induced utilization, particularly in Medicare as individuals looked at their changing benefits in '25 and seek to utilize benefits that will no longer be available next year.

第三，我們做出了一項規定，可能會有一些適度的誘導利用，特別是在醫療保險方面，因為個人會考慮他們在25 年不斷變化的福利，並尋求利用明年將不再提供的福利。

And then finally, we noted the group Medicare trend levels that if they persisted at that level, I just referenced that could cause us to take an additional PDR in the fourth quarter, but that will really depend on what we think the baseline is for '24 and how it is that that's going to persist into '25.

最後，我們注意到團體醫療保險趨勢水平，如果他們持續在這個水平，我剛剛提到這可能會導致我們在第四季度採取額外的 PDR，但這實際上取決於我們認為的基線是什麼' 24以及如何將這種情況持續到25。

So more to come on that.

所以還有更多的事情要做。

I would note, finally, our reserve balances through October.

最後，我要指出我們十月份的準備金餘額。

They have been modestly positive, but we've continued to see pressure in the more recent dates of service, for example, in the third quarter.

它們一直是適度積極的，但我們在最近的服務日期（例如第三季）中繼續看到壓力。

Stephen Baxter, Wells Fargo.

史蒂芬‧巴克斯特，富國銀行。

Yeah, hi.

是的，嗨。

Thanks.

謝謝。

Just a couple of quick ones.

只是幾個快速的。

So you did mention that in response to that question, it's important to differentiate the incremental trend that's coming out of benefits that have already been restructured for 2025 versus more potentially core areas of utilization.

因此，您確實提到，在回答這個問題時，區分 2025 年已經重組的福利與更多潛在核心利用領域所帶來的增量趨勢非常重要。

So maybe could you help us understand better what you saw in the third quarter?

那麼您能否幫助我們更了解您在第三季看到的情況？

And then just on the PDR commentary for 2025, you're citing you potentially need one for group me, but you're not saying you need one for individual MA or potentially the exchanges.

然後，就 2025 年 PDR 評論而言，您指出您可能需要為我組提供一個，但您並不是說您需要為個人 MA 或潛在的交流提供一個。

Just wondering why or when not that would be the case.

只是想知道為什麼或何時不會發生這種情況。

Thank you.

謝謝。

Let me answer the second part first.

我先回答第二部分。

So the way the PDRs are calculated is partially based on how those products are sold and so are individual Medicare products are differently grouped than how our group Medicare products are.

因此，PDR 的計算方式部分取決於這些產品的銷售方式，因此單一 Medicare 產品的分組方式與我們的團體 Medicare 產品的分組方式不同。

And as you can imagine, the nature of the contracts in the group business tends to be multiyear and so there's less ability to make improvement year-over-year.

正如您可以想像的那樣，集團業務中的合約性質往往是多年期，因此逐年改進的能力較小。

And so that business has a different profile going into '25 than the individual business in Medicare does or the individual exchange business does.

因此，進入 25 世紀，該業務的概況與 Medicare 中的個人業務或個人交換業務不同。

We haven't really talked a lot about the exchange business, but that's a $10 billion block of revenue in 2024 with over 1.9 million members.

我們還沒有真正談論過交易所業務，但到 2024 年，該業務的收入將達到 100 億美元，擁有超過 190 萬會員。

As David noted, we unfortunately grew that business too fast.

正如大衛所指出的，不幸的是我們的業務發展得太快了。

We're suffering significant losses in '24, mostly led by our SEP members.

我們在 24 年遭受了重大損失，主要是由我們的 SEP 成員造成的。

This pressure was compounded by unfavorable metal product mix, which skewed to certain geographies.

這種壓力因不利的金屬產品結構而加劇，這種結構偏向某些地區。

We have taken, as I believe we previously discussed, double-digit rate increases across this book for next year and as a deliberate consequence of that rate action.

正如我相信我們之前討論過的那樣，我們已經將明年的本書中的兩位數利率上調，並將其作為該利率行動的故意結果。

We expect we could shrink that book by as much as 20% to 25% next year.

我們預計明年該書的規模可能會縮減 20% 至 25%。

So those actions, combined with some of the operational improvements that the teams are making on the ground should also help to improve performance next year, which is part of the reason that at this point, we don't anticipate that we would need a PDR in that individual business.

因此，這些行動，再加上團隊在實地進行的一些營運改進，也應該有助於提高明年的績效，這也是目前我們預計不需要 PDR 的部分原因在那項個人業務中。

As it relates to trend, we have continued to see supplemental benefit trends be elevated throughout all of 2024 and that persisted into the third quarter, where we've also seen trend pressure, as I noted in the prepared remarks, has been in all the usual suspects this year.

就趨勢而言，我們繼續看到補充福利趨勢在 2024 年全年都在上升，並且這種情況一直持續到第三季度，正如我在準備好的發言中指出的那樣，我們也看到了趨勢壓力今年的常見嫌疑犯。

It's been inpatient.

已經住院了

It's been in outpatient, although the types of procedures that we've seen have shifted somewhat. -- we continue to see pressure on things like medical pharmacy, particularly on some of the oncology drugs.

儘管我們看到的手術類型有所改變，但它是在門診進行的。 ——我們繼續看到醫療藥學等領域面臨壓力，特別是一些腫瘤藥物。

And so it's a lot of the same things that we have been talking about throughout the whole year.

因此，我們一整年都在談論很多相同的事情。

The piece that I was mentioning in terms of the bridge is -- there is a large portion of that trend increase that is a function of some of the supplemental benefits that we have offered, and those have been fundamentally restructured next year for individual Medicare products.

我在橋樑方面提到的部分是——這種趨勢增長的很大一部分是我們提供的一些補充福利的函數，這些福利明年將針對個人醫療保險產品進行根本性重組。

And we'll give you better insight as to what that was worth when we have a better sense as to how the mix has come out and what the baseline is for '24.

當我們更了解混合結果以及 24 年的基線是什麼時，我們會讓您更了解它的價值。

Stephen, this is David.

史蒂芬，這是大衛。

Maybe just a quick follow-on here.

也許只是這裡的快速跟進。

This is the third question on the Q4 jump up.

這是第四季跳躍的第三個問題。

And I think it's important to recognize that we know what the problems are.

我認為重要的是要認識到我們知道問題是什麼。

Clearly, we've stated them in the prepared remarks.

顯然，我們已經在準備好的發言中闡述了這些內容。

We understand kind of the broader issues that are challenging the '24 performance.

我們了解一些更廣泛的問題正在挑戰 24 小時的表現。

The good news is we're proactively addressing those as we -- as you've seen in terms of how we structured the product design and the benefits.

好消息是，正如您在我們如何建立產品設計和優勢方面所看到的那樣，我們正在積極解決這些問題。

You've seen changes in how we've structured our leadership teams, seen changes in terms of how we structured our risk management and pricing controls, so we believe that we're on the path of actually getting to an improved performance.

您已經看到了我們建立領導團隊的方式的變化，看到了我們建立風險管理和定價控制方式的變化，因此我們相信我們正在真正提高績效。

And so quickly, we can move past '24 and into '25, I think the better will continue to be for the collective group.

如此之快，我們就可以跨過 24 年進入 25 年，我認為集體團體將繼續變得更好。

Michael Cherny, Leerink Partners.

邁克爾·切爾尼，Leerink Partners。

Good morning, and thanks for all the color.

早上好，感謝所有的顏色。

Maybe I'll try and take this a different direction and talk about pharmacy services.

也許我會嘗試採取不同的方向並談論藥房服務。

You talked about Tom next year being a bit below long-term plan.

你談到湯姆明年的表現有點低於長期計畫。

Can you break that down within the Health Services segment between core services versus the health delivery assets and specifically tied to pharmacy services how are you thinking about both specialty utilization as well as the continued contribution of

您能否在健康服務領域中將其細分為核心服務與健康服務資產之間的關係，特別是與藥房服務相關的問題，您如何考慮專業利用以及持續貢獻

[code as always].

[一如既往的程式碼]。

As you sit here today, taking through where the jump-off point of fiscal '25 again for the Health Services segment can go.

當您今天坐在這裡時，再次回顧一下 25 財年醫療服務部門的起點。

Thanks, Mike.

謝謝，麥克。

As you think about the Health Services segment, we got a little bit of a slow start in 2024.

考慮到健康服務領域，我們 2024 年的開局有點緩慢。

But that business -- that team has done an exceptional job of really driving momentum and we've seen that momentum accelerate into the second and into the third quarter, which is really given us a lot of confidence in the outlook as we think about this year.

但該業務——該團隊在真正推動勢頭方面做得非常出色，我們已經看到這種勢頭在第二季度和第三季度加速，這確實讓我們在考慮這一問題時對前景充滿信心年。

As we think about next year, I'd say given that slow start, we don't want to get ahead of ourselves.

當我們考慮明年時，我想說，鑑於開局緩慢，我們不想超越自己。

And so while we're not providing formal guidance today, we want to make sure that we appropriately set expectations given how that was a little bit choppy out of the gate last year.

因此，雖然我們今天沒有提供正式的指導，但考慮到去年的情況有點不穩定，我們希望確保適當地設定預期。

And this is David, obviously, now division, I know much better in terms of the performance.

這是大衛，顯然，現在是師，我在表現方面更了解。

And I will say we're going to finish '24 strong.

我想說的是，我們將在 24 屆比賽中保持強勢。

And if you look at the 25-year, -- we're actually heading into a really strong selling season. (inaudible) momentum as it relates to the success we've had on the biosimilar launch, changing and disrupting the market as it relates to pricing models, the client satisfaction and member NPS scores are as high as they've been.

如果你看看 25 年，我們實際上正在進入一個非常強勁的銷售季節。 （聽不清楚）勢頭，因為它與我們在生物仿製藥上市方面取得的成功有關，改變和擾亂了市場，因為它與定價模型有關，客戶滿意度和會員 NPS 分數與以往一樣高。

So I believe just collectively, this business is running really well and still feel very strong about its continued performance into '25.

因此，我相信，從整體上看，該業務運作得非常好，對其 25 年的持續表現仍然感到非常強勁。

Josh Raskin, Nephron Research.z

喬許‧拉斯金 (Josh Raskin)，Nephron Research.z

Hi.

你好。

Thanks.

謝謝。

Good morning.

早安.

Just a clarification on the PDR time.

只是對 PDR 時間進行澄清。

So I want to make sure I understood what you said that no PDRs havebeen contemplated for 2025.

因此，我想確保我理解您所說的，即 2025 年沒有考慮 PDR。

So MA and [hicks] lost money in totality in '24 and will be positive in 2025.

因此，MA 和 [hicks] 在 24 年總共虧損，但到 2025 年將會虧損。

I just want to make sure we got that right.

我只是想確保我們做對了。

And then more importantly, can you speak to your updated Medicare, both MA and PDP distribution strategy?

更重要的是，您能否談談更新後的 Medicare（MA 和 PDP 分配策略）？

And I'm specifically interested in your commission strategy with external brokers and feedback you guys are getting on that.

我對你們與外部經紀人的佣金策略以及你們得到的回饋特別感興趣。

Thanks, Josh.

謝謝，喬許。

On the PDR, the PDR is a pretty [esoteric] accounting rule.

關於 PDR，PDR 是一個相當[深奧]的會計規則。

And so it looks at the business and looks at it on a variable cost basis.

因此，它會以可變成本為基礎來審視業務。

And as we look at and think about our projections for next year, with the improvements that we are expecting in -- across those books.

當我們審視並思考明年的預測時，以及我們期望在這些書中取得的改進。

The only one that we think might be close to the line is the group Medicare business, which is why we highlighted that for investors.

我們認為唯一可能接近該線的是集團醫療保險業務，這就是為什麼我們向投資者強調這一點。

But I wouldn't take that to mean that we are necessarily going to be profitable because you have to allocate out those fixed costs, which are fairly substantial as you think about the fixed costs associated with those two large businesses.

但我並不認為這意味著我們一定會獲利，因為你必須分配這些固定成本，當你考慮到與這兩家大型企業相關的固定成本時，這些固定成本相當可觀。

.

。

As you think about our strategy for both MA and PDP, we are going to shrink membership in PDP.

當您考慮我們針對 MA 和 PDP 的策略時，我們將減少 PDP 的成員數量。

We do use a lot of broker channels.

我們確實使用了很多經紀人管道。

Only about 15% of what we do is actually from internal channels.

我們所做的工作實際上只有大約 15% 來自內部管道。

The rest of it is from external channels where we have large, long and established relationships.

其餘部分來自外部管道，我們在這些管道中擁有廣泛、長期且已建立的關係。

We're generally very pleased with where it is that our early sales are coming out.

總的來說，我們對早期銷售的結果感到非常滿意。

We are obviously, throughout this process of open enrollment, we make tweaks to that as we look at where geographies are coming in and think about where we want to grow and where we might want -- might not want to grow as quickly.

顯然，在整個開放註冊過程中，我們會對此進行調整，因為我們會考慮哪些地區正在進入，並思考我們想要在哪裡增長以及我們可能想要在哪裡增長——可能不想增長得那麼快。

But overall, where AEP is coming out as of the end of last week, is very consistent with where we had mapped it, maybe a little bit of mix difference, but generally in line with -- in the aggregate with where we had thought about it.

但總體而言，截至上週末，AEP 的發布位置與我們繪製的位置非常一致，可能存在一點混合差異，但總體而言與我們考慮的位置一致它。

And so we were pretty pleased with the performance today.

所以我們對今天的表現非常滿意。

Elizabeth Anderson, Evercore ISI.

伊麗莎白·安德森，Evercore ISI。

Hi, guys.

嗨，大家好。

Thank you so much for the question this morning.

非常感謝你今天早上提出的問題。

Maybe just one question about the PDR OpEx mechanics that you guys talked about in the third quarter, people , the third quarter PDR.

也許只是你們在第三季談論的 PDR OpEx 機制的一個問題，第三季的 PDR。

Does that from an OpEx perspective, does that become a positive to your numbers in the fourth quarter?

從營運支出的角度來看，這會對您第四季的業績產生正面影響嗎？

That would be my first question.

這是我的第一個問題。

And then secondarily, can you just maybe dig in a little bit more on the PCW strength?

其次，您能否進一步挖掘 PCW 的實力？

How do we expect sort of that cadence to change as we think about the pull forward from COVID and then any kind of seasonality you guys are thinking about for the fourth quarter?

當我們考慮到新冠疫情的影響以及你們正在考慮的第四季度的季節性因素時，我們預計這種節奏會如何改變？

Thank you.

謝謝。

Maybe I'll take the PDR mechanic, and then Prem, you can talk a little bit about the PCW strength.

也許我會選擇 PDR 機制，然後 Prem，你可以談談 PCW 的實力。

On the PDR mechanic, the way that this works is that you look at what the potential losses might be on a variable basis.

在 PDR 機制中，其工作原理是您在可變的基礎上查看潛在的損失。

You record the PDR and really how you record it is that one of the first places you have to look is you have to look at any deferred acquisition costs that you have hung up on the balance sheet.

您記錄 PDR，實際上您如何記錄它，您首先要查看的地方之一是您必須查看掛在資產負債表上的任何遞延購置成本。

And so you recruit for that, you take those down first -- that means that while you're not really reversing a reserve, you don't have expense that you otherwise would have anticipated happening in the fourth quarter.

因此，你為此招募人員，首先將其撤下——這意味著，雖然你沒有真正撤銷儲備金，但你沒有預期在第四季度發生的費用。

So it is an expense benefit and an MLR benefit.

因此，它既是費用收益也是 MLR 收益。

So the vast majority of that $1.1 billion will come back in the fourth quarter.

因此，這 11 億美元中的絕大多數將在第四季度收回。

.

。

And on the PCW strength, I'd say a few things.

關於 PCW 的實力，我想說幾句話。

First and foremost, we had a really strong quarter.

首先也是最重要的是，我們有一個非常強勁的季度。

Part of that was driven by immunization season coming sooner than we expected, started in mid-August versus later in that month or early September.

部分原因是免疫季節比我們預期的要早到來，從八月中旬開始，而不是當月晚些時候或九月初。

And we had a first market mover there.

我們在那裡有第一個市場推動者。

We were ready for that.

我們已經準備好了。

Our teams are prepared we've been preparing for that season for the most part of the year.

我們的團隊已經做好準備，我們一年中的大部分時間都在為這個賽季做準備。

The second piece, I would say, is around our core service levels continue to remain very strong.

我想說的第二點是我們的核心服務水準持續保持非常強勁。

We've continued to improve our NPS levels are up hundreds of basis points year-over-year.

我們不斷提高 NPS 水平，比去年同期提高了數百個基點。

And that's turning into, what I would say, strong script growth as it relates to our pharmacy business, now around 27.3%, up 70-plus basis points year-over-year.

我想說的是，這正在變成與我們的製藥業務相關的強勁腳本增長，目前約為 27.3%，同比增長 70 多個基點。

So another great example of a strong service driving script growth in our Pharmacy segment of that business.

這是另一個很好的例子，說明強大的服務推動了我們製藥業務的腳本成長。

And on the front store, as Tom alluded to, there was some front store pressure, but our front store business continues to improve in a difficult market -- in a difficult market environment, and we continue to do the right things around focusing on gaining customers and increasing foot traffic on that business as we go into it and really kind of mitigating some of the challenges we had earlier in the year.

在前置店方面，正如湯姆所提到的，存在一些前置店壓力，但我們的前置店業務在困難的市場中繼續改善——在困難的市場環境中，我們繼續圍繞著專注於盈利做正確的事情隨著我們進入該業務，客戶數量和人流量不斷增加，這確實緩解了我們今年早些時候遇到的一些挑戰。

So the PCW segment, really proud of our results, really proud of the leadership team and all the results that we've driven in that area, and it's continued to be a strength of our business.

因此，PCW 部門對我們的業績感到非常自豪，並對領導團隊以及我們在該領域取得的所有成果感到非常自豪，而且它仍然是我們業務的優勢。

This is David.

這是大衛。

Maybe just to reinforce Prem's point here.

也許只是為了強化普雷姆的觀點。

Obviously, the retail sector has pressured lots of headwinds in this market.

顯然，零售業為這個市場帶來了許多阻力。

And if you look at what Prem and the team have been able to deliver and execute is really incredibly impressive.

如果你看看 Prem 和團隊所交付和執行的成果，確實令人印象深刻。

Share growth, while you're contracting a footprint service levels are up, and this is kind of all despite, obviously, pressures around this sector.

份額增長，當你收縮足跡時，服務水平上升，儘管顯然，這個行業面臨壓力，但這一切都是如此。

So I'm incredibly excited about Prem's expansion of his role and responsibility to take that same focus on execution and operational excellence and to the broader business.

因此，我對 Prem 擴大其角色和責任感到非常興奮，他將同樣關注執行和卓越營運以及更廣泛的業務。

Andrew Mok, Barclays.

安德魯·莫克，巴克萊銀行。

Hi.

你好。

Good morning.

早安.

Wanted to follow up on Medicare Advantage margins.

想要跟進 Medicare Advantage 利潤率。

With the lower margin level that you're seeing today, I was hoping you can give us an update on how you're thinking around the pace of MA margin improvement over the next few years.

鑑於您今天看到的利潤率水平較低，我希望您能給我們提供最新信息，說明您對未來幾年 MA 利潤率改善步伐的看法。

And in your prepared remarks, you noted the journey back to target MA margins of 3% to 5%.

在您準備好的發言中，您提到了回到 3% 至 5% 目標 MA 利潤率的過程。

That's a slight change from your previous target of 4% to 5%.

這與您之前 4% 到 5% 的目標相比略有變化。

So just curious what drove that change and why 3% to 5% is the appropriate margin level.

所以只是好奇是什麼推動了這一變化，以及為什麼 3% 到 5% 是合適的保證金水準。

Thanks.

謝謝。

Let me answer the second part first because the answer to that question is really primarily mathematical, right?

讓我先回答第二部分，因為這個問題的答案其實主要是數學上的，對嗎？

So as you think about the IR at changes to the Part D program, significant dollars that were previously recorded as reinsurance, are now going to get recorded as premium, which increases the denominator of the calculation.

因此，當您考慮 D 部分計劃變更時的 IR 時，先前記錄為再保險的大量資金現在將記錄為保費，這增加了計算的分母。

So at constant dollars of margin, that change alone is significant to drive a 4% margin down into the

因此，在保證金不變的情況下，僅此一項變化就足以將利潤率降低 4%

[3s].

[3秒]。

As you think about the longer term, it's a challenging question to answer.

從長遠來看，這是一個很難回答的問題。

We understand and we made deliberate changes to benefits to be able to drive improvement in margin next year.

我們理解，並且我們對福利進行了有意的改變，以便能夠推動明年利潤率的提高。

We anticipate that we'll be able to continue to do that into 2026.

我們預計我們將能夠繼續這樣做到 2026 年。

And our Star scores will help there, right?

我們的星級評分會有所幫助，對嗎？

We had great [stars] performance. 2/3 of our members will be in 4.5-star plans that will provide a little bit of additional tailwind as well.

我們的表現非常出色。我們 2/3 的會員將加入 4.5 星級計劃，這也將提供一點額外的優勢。

But we really need to understand what the rate environment looks like to be able to answer that question.

但我們確實需要了解利率環境如何才能回答這個問題。

But our goal would be to increase margins again in 2026 in that business.

但我們的目標是在 2026 年再次提高該業務的利潤率。

Yes.

是的。

Just as it relates to the focus, obviously, my near-term focus is driving and accelerating the performance of that business.

正如它與重點相關一樣，顯然，我近期的重點是推動和加速該業務的績效。

So as Tom mentioned, the star tailwind will be very positive for both '25 and into '26.

正如 Tom 所提到的，明星順風對於 25 年和 26 年都將是非常積極的。

There will be a very strong focus on total cost of care.

人們將非常關注總護理成本。

So as we know what the pricing and the benefits are for the risk that we're managing to make sure we have the underlying clinical resources and total cost of care models to manage the risk appropriately.

因此，當我們知道我們正在管理的風險的定價和收益是多少時，我們就能確保我們擁有基礎的臨床資源和總護理成本模型來適當地管理風險。

And then lastly, you'll see an acceleration of how we integrate the assets within this business to help us drive down the cost and improve the overall experience for the members that we're serving.

最後，您將看到我們如何加速整合該業務中的資產，以幫助我們降低成本並改善我們所服務的會員的整體體驗。

So again, just reinforcing the fact that this is a really important product for our business. and one that we're going to have the collective enterprise focused on execution.

再次重申，這對我們的業務來說是一個非常重要的產品。我們將讓集體企業專注於執行。

John Ranson, RJF.

約翰·蘭森，RJF。

Hey, good morning.

嘿，早安。

Signify and Oak are they tracking in line with your expectations and you think that will -- that trend will change in any way next year?

Signify 和 Oak 的表現符合您的預期嗎？

Signify has had a great year.

昕諾飛度過了美好的一年。

As we noted, the volume was up, I think, 37% year-over-year inside the third quarter.

正如我們所指出的，我認為第三季的銷量同比增長了 37%。

That business has continued to perform very well.

該業務繼續表現良好。

Oak Street overall has performed in line with the guidance that we gave at the earlier part of the year.

橡樹街的整體表現符合我們今年早些時候給出的指導。

They are a Medicare focused business.

他們是一家專注於醫療保險的企業。

And so they're not immune to some of the pressures that others have seen in that marketplace because of the nature of that membership.

因此，由於會員資格的性質，他們也無法避免其他人在該市場中看到的一些壓力。

But we've been very pleased with how they performed.

但我們對他們的表現非常滿意。

They've maintained a risk adjustment headwind that's plus or minus a little bit below 3%, which we feel is a great first step given the first year of the implementation of the

他們保持了正負略低於 3% 的風險調整逆風，考慮到實施第一年，我們認為這是一個很好的第一步。

['28].

['28]。

And we think that there could be some nice tailwinds in that business next year as we think about some of the changes that our competitors and ourselves have need as we continue to grow our share of Aetna members inside those clinics.

我們認為，隨著我們繼續增加這些診所內 Aetna 會員的份額，我們會考慮我們的競爭對手和我們自己需要做出的一些改變，因此明年該業務可能會出現一些良好的順風車。

And just to reinforce the importance of both of those acquisitions.

只是為了強調這兩項收購的重要性。

Oak Street, obviously, is managing the cost part better than the rest of our book.

顯然，橡樹街對成本部分的管理比我們書中的其他部分更好。

So the fact is the model works and it works in an underserved market, specifically for a population that's important to this business.

所以事實是這個模式是有效的，而且它在一個服務不足的市場中有效，特別是對於對這個業務很重要的人群。

And the integration between Aetna and Oak Street are improving.

安泰保險 (Aetna) 和橡樹街 (Oak Street) 之間的整合正在不斷改善。

So we've had a 4x increase in the members since the acquisition.

自收購以來，我們的會員數量增加了 4 倍。

So proving out the fact that when we put the collective efforts of the business, we can actually see performance.

所以證明了一個事實，當我們把業務的集體努力放在一起時，我們確實可以看到績效。

Same thing on Signify.

昕諾飛也有同樣的情況。

We've seen a 2x increase and the members served within Aetna.

我們看到成員人數增加了 2 倍，並且成員在 Aetna 內部任職。

The goal here is obviously to use Signify as a platform, the sophistication and the technology that they've invested around the logistics and reaching members in their homes, it is a platform which we can certainly build beyond just the in-home assessment.

這裡的目標顯然是使用 Signify 作為一個平台，他們在物流和到達會員家中所投資的複雜性和技術，這是一個我們當然可以建立的平台，而不僅僅是家庭評估。

So that will be the message and the focus of the business to continue to serve people, both in the care delivery setting as well as in the home, and we believe we have the appropriate assets to be able to execute that.

因此，這將是繼續為人們提供服務的資訊和業務重點，無論是在護理服務環境還是在家中，我們相信我們擁有適當的資產來執行這一目標。

Thank you.

謝謝。

Brian Tanquilut, Jeffries.

布萊恩·坦奎魯特，傑弗里斯。

Hey, good morning.

嘿，早安。

Thanks for the update on the cost advantage program.

感謝您更新成本優勢計劃。

So just curious what those discussions have been like?

所以只是好奇這些討論是什麼樣的呢？

And how did the contracts shake out in terms of what you expected pricing structures to look like versus what the -- that 50% of the book looks like?

就您預期的定價結構與本書 50% 的內容而言，合約是如何變化的？

And -- how are you thinking about the opportunity or the ability to increase that number before we get to January 1?

您如何看待在 1 月 1 日之前增加這一數字的機會或能力？

Thanks.

謝謝。

Yes.

是的。

So first and foremost, as you recall, last year, we launched Cost Vantage with the very intentional reason to solve one of the biggest industry challenges we had around reimbursement pressure.

因此，首先也是最重要的是，正如您所記得的那樣，去年我們推出 Cost Vantage 的目的是為了解決我們在報銷壓力方面面臨的最大行業挑戰之一。

And so -- we've made really good progress, as David and Tom alluded to in the prepared remarks.

因此，正如大衛和湯姆在準備好的演講中提到的那樣，我們取得了非常好的進展。

We have over 50% of our clients in the program.

我們有超過 50% 的客戶參與了該計劃。

We expect to have our commercial book, 100% of our commercial book signed by the end of this year.

我們預計到今年年底我們的商業書將簽署100%。

I'm really excited about what it brings to the marketplace and how we -- and some of the cross subsidization that exist in pharmacy as it relates to this.

我對它為市場帶來的東西以及我們如何——以及與此相關的藥房中存在的一些交叉補貼感到非常興奮。

So we continue to make really good progress.

所以我們繼續取得非常好的進展。

As it relates to the financial outlook from cost management, we'll come back to early next year with what we're seeing.

由於它與成本管理的財務前景有關，我們將在明年初回顧我們所看到的情況。

But we continue to see really strong performance, as I mentioned earlier, in our retail pharmacy business.

但正如我之前提到的，我們的零售藥品業務仍然表現強勁。

We're really excited about what cost [manage] will bring to the marketplace and how it's going to transform the way we price pharmaceuticals in this country.

我們對成本[管理]將為市場帶來什麼以及它將如何改變我們在這個國家的藥品定價方式感到非常興奮。

And lastly, the benefits that it brings to consumers as well.

最後，它帶給消費者的好處。

So more to come.

未來還會有更多。

But at this point, I would say we continue to make really great progress here. across the board of moving the industry.

但在這一點上，我想說我們繼續在這方面取得巨大進展。全面帶動產業發展。

So I'd just follow on to Prem's comment about Cost Vantage.

因此，我只想跟進 Prem 對 Cost Vantage 的評論。

And we -- if you look at the complexity of pharmaceutical pricing in this country.

如果你看看這個國家藥品定價的複雜性，我們就會發現。

This is obviously one of the paths in which to address the confusion and the complexity of how drugs actually are priced at the consumer level.

這顯然是解決消費者層面藥品實際定價方式的混亂和複雜性的途徑之一。

So prems move in the retail setting, combined with the true cost drive within the PBM, we believe it's a concerted effort to address what we know is a headline around the confusion, the complexity of the pricing.

因此，Prems 在零售環境中的發展，再加上 PBM 中真正的成本驅動，我們相信，這是一項共同努力，旨在解決我們所知道的圍繞定價混亂和複雜性的頭條新聞。

So -- this elimination across subsidation, the ability to get to a more stable and less variable pricing strategy will help us solve what we know is a headline risk and more importantly, allow us to serve our members and our clients more effectively.

因此，消除補貼、採取更穩定、變化更少的定價策略的能力將幫助我們解決我們所知道的主要風險，更重要的是，使我們能夠更有效地為我們的會員和客戶提供服務。

So with that, we -- this ends the call.

這樣，我們就結束通話了。

And I -- before closing here, I just want to thank for you for all joining the call today.

在結束之前，我只想感謝大家今天加入電話會議。

I'm incredibly excited and humbled by the opportunity and the potential of this combined enterprise.

我對這家合併後的企業所提供的機會和潛力感到無比興奮和謙卑。

We have clear line of sight into the issues and the plan is in place to address them.

我們對這些問題有清晰的認識，並已製定解決這些問題的計劃。

We look forward to providing updates on our progress going forward.

我們期待提供有關我們未來進展的最新資訊。

And I also just want to thank again the 300,000 colleagues to help us serve our customers and our patients day in and day out.

我還要再次感謝 30 萬名同事日復一日地幫助我們為客戶和患者提供服務。

So thank you for that support.

感謝您的支持。

Thank you all for joining today's conference call with CVS Health.

感謝大家參加今天與 CVS Health 的電話會議。

I can confirm today's call has now concluded.

我可以確認今天的通話現已結束。

Please enjoy the rest of your day, and you may now disconnect from the call.

請享受您今天剩下的時間，您現在可以掛斷電話了。